Pain MeasurementAs always, new links are marked for about one month with a small flashing bulb:

The accurate quantification of pain has been a goal of physicians since the profession had its roots in ancient Greece. The most troublesome aspect of such studies is the wide disparity with which each individual experiences pain, not only basic responsiveness of pain nerve receptors, but the diverse emotional reaction to pain.

In fact, the emotional involvement with intense pain is an important interpersonal variable, and much of the action of some analgesics (particularly the opioids) is based on their ability to remove the patient, psychologically, from the pain experience. Patients often describe the experience with words like "It definitely hurts less, but I feel detached from the remaining pain - it doesn't seem to bother me as much".

The organization of this section is fairly intuitive. We start with collections of pain assessment tools, published by an organization that may or may not have a financial relationship with the vendors of the product they're selling. When detected, these are noted.

Following this is a series of assessment instruments used by hospitals, private physicians, and many other healthcare providers. I hope this gives you a good feel for what's currently available and how reliable it is.

The source is actually part of DHHS, and this authoritative, well-referenced book is available at no cost. Although it concentrates on cancer pain, we all know how applicable much pain-fighting technology is to CRPS/RSD.

Depression and associated pain is at least as prevalent in CRPS as in cancer, and this research article has lots of excellent information and even more references - nearly 100 for a paper that's maybe five pages long!

"Pain scales and checklists offered in this section are useful for clinically assessing how intensely patients are feeling pain and for monitoring the effectiveness of treatments at different points in time."

A very good piece from the About.com site which features the six most common rating scales, including graphics that show what each test looks like. Included is the McGill scale as well as several less-known scales. Very valuable!

"On my rehabilitation unit, we use pain scales every day. The one we use the most often is the numerical pain rating scale (the NRS), likely for it's convenience. It's easy to ask someone to pick a number, and then to write it down for later reference. Provided, of course, that you remember to write it down! "

"When you have chronic pain, it’s easy to become jaded about using a pain scale. You’re asked to rate your pain every time you see your doctor. You fill out pain questionnaire after pain questionnaire. You are asked to assign words to your pain, again and again. Eventually you may wonder: how is this helping?"

"When I was in occupational therapy school, we learned to divide pain scales into two types: quantitative and qualitative. In other words, those you can use to measure pain, and those that describe pain, respectively. Both have advantages and disadvantages."

Published in NEJM, the first objective measurement of one's pain, as measured by functional magnetic resonance imaging (fMRI). More research is needed, but this could revolutionize pain treatment, especially for nonverbal patients, including nonhuman animals.

A very good, easily-understandable article on the fMRI technique described in the two above scientific papers. Topic sentence: "The findings, published on April 10 in the New England Journal of Medicine, may lead to the development of reliable methods doctors can use to objectively quantify a patient's pain."

"The Symptom Checklist-90-R (SCL-90-R) instrument helps evaluate a broad range of psychological problems and symptoms of psychopathology. The instrument is also useful in measuring patient progress or treatment outcomes."

A 20-page presentation, formatted as a series of slides, of the many types of pain measurement methods available.

Examples of McGill pain scales

Here's a selection of a few McGill pain scales from various sources. To see the full-sized images, just click an image below.

Hey, want to know your BMI (body-mass index)? RSD itself can cause weight gain/loss, and many of the drugs commonly used for the illness are notorious for causing fluctuations in body weight. This small utility, hosted by the New York Times, requests only your height and weight, then explains what the numbers mean.